NPIMap

Individual provider Active NPI

Jonathan Michael Gross, M.D.

  • Medical Oncology Physician
  • Corvallis, OR
National Provider Identifier
1457593881
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
MD165536 Issued in OR
Practice address
444 NW Elks Dr
Corvallis, OR 97330-3745
Phone
(541) 754-1256
Fax
(360) 517-1472
NPI assigned
Mar 31, 2009
Last updated
Mar 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD165536 OR
Medical Oncology Physician 207RX0202X MD165536 OR Primary

Addresses

Primary practice location

444 NW Elks Dr
Corvallis, OR 97330-3745

Mailing address

520 Country Club Rd
Eugene, OR 97401-6043
Phone (541) 683-5001

Other identifiers 1

IdentifierTypeStateIssuer
500673731MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140922000828 OR Practitioner - Internal Medicine 2062659352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loma Linda University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

444 NW Elks Dr
Corvallis, OR 97330-3745
Phone (541) 754-1256

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD165536ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oncology Associates of Oregon P C CurrentSince Dec 1, 2019 Accepting new patients
Oncology Associates of Oregon P C Medical Oncology CurrentSince Dec 1, 2019 Accepting new patients

Locations

2615 Willetta St SW
Albany, OR 97321

2615 Willetta St SW
Ste C2
Albany, OR 97321
Phone (541) 754-1256

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

444 NW Elks Dr
Corvallis, OR 97330
Phone (541) 754-1256

520 Country Club Pkwy
Eugene, OR 97401
Phone (541) 681-4948

3015 NE West Devils Lake Rd
Lincoln City, OR 97367
Phone (541) 994-5591

2039 N Coast Hwy
Newport, OR 97365
Phone (541) 754-1256

Interoperability endpoints

  • Direct secure messaging: jgross122528@samhealth.direct-ci.com
  • Direct secure messaging: jmgross@yourcarecommunity.org
  • Direct secure messaging: jonathan.gross@wvci.ikm.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 74

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 74

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1457593881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 COUNTRY CLUB RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016043",
            "telephone_number": "541-683-5001",
            "fax_number": "541-683-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 NW ELKS DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303745",
            "telephone_number": "541-754-1256",
            "fax_number": "360-517-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "JONATHAN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-31",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD165536",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "OR",
            "license": "MD165536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500673731",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.